Disease Activity in Untreated Patients of Rheumatoid Arthritis in Eastern India
OC31-OC33
Correspondence
Dr. Anirban Ghosh,
Flat 2A, Fountain Exotica, 432 Mahamayatala, NSC Bose Road, Kolkata-700103, West Bengal, India.
E-mail: ani.medico@gmail.com
Introduction: Rheumatoid Arthritis is a common chronic inflammatory disease, causing joint pain damage and disability. Assessment of disease activity is an important step in optimal management of these patients.
Aim: To describe the disease activity in untreated Indian patients with rheumatoid arthritis.
Materials and Methods: A cross-sectional observational study was done on 86 consecutive patients attending Medicine Outpatient Department (OPD) of a tertiary care hospital in eastern India and were with definite rheumatoid arthritis as per 2010 classification criteria who never received any Disease Modifying Anti Rheumatic Drugs (DMARDs) or steroids. Tender and swollen joint count out of 28 joints was measured along with Erythrocyte Sedimentation Rate (ESR) and patient’s assessment of his/her global health on a Visual Analogue Scale (VAS). Disease Activity Score (DAS) for 28 joints with ESR value (DAS28-ESR) was calculated for each patient by medical calculator app based on these variables and then patients were classified into having high, moderate or Low Disease Activity (LDA) based on the DAS28-ESR values.
Results: The ratio of female: male patients were 3.5:1. The average age of the patients was 38.17 years. The mean DAS28-ESR value was 6.19 and majority of the patients (81%) were in the High Disease Activity (HDA) group. The patient reported global health assessment which was also very high (mean 64.12/100 mm).
Conclusion: Most of the untreated rheumatoid arthritis patients in our community are in a HDA group and presents with significantly higher amount of pain and disabilities. This finding underlines the need to improve the screening of arthritis in our community to reduce the number of patients who would present to health facilities with advanced disease having irreversible deformities resulting in disabilities. This would result in early increase in the number of pain free days for the patient and also reduce the overall cost of therapy.